Stereotactic Body Radiotherapy (SBRT) has gained wide acceptance for the treatment of cancer. In SBRT a patient is given repeated doses of radiation over an extended period of time. In order to ensure that the appropriate radiation dose is accurately delivered to the tumor each time that the patient is given a radiation treatment, various devices and systems are commercially available to hold or fix or hold in position the portion of the patient to which the radiation is to be directed. Such systems are sometimes referred to as patient positioning systems and serve to keep the patient as still as possible when the treatment beam is on. Patients undergoing SBRT typically are disposed on a treatment couch or table associated with a LINAC or other radiation therapy apparatus. Various couchtops and overlays are commercially available for disposition on the treatment couch, with the patient being disposed on the couchtop/overlay. As is known such support devices are disposed on top of the cradle, existing support frame and/or spine of a CT, simulator or LINAC. For SBRT applications it is a common practice to position and fix a portion of the patient so that repeated treatment can be given to the patient. To that end, some indexing system is provided for mounting and positioning various patient positioning and/or fixation devices on the couchtop or overlay at predetermined positions with respect to the couchtop/overlay. Examples of such patient positioning/fixation devices are head and neck positioning/fixation devices, breast and thorax positioning/fixation devices, and hip and pelvic region positioning/fixation devices. Many of such devices, as well as other miscellaneous positioning aids, e.g., cushions, wedges, etc., for use on the treatment couchtop/overlay are available from Civco Medical Solutions (hereinafter “CIVCO”).
For example, CIVCO offers a BODY PRO-LOK™ system which aids in providing comfortable, total body immobilization for lengthy hypo-fractionation treatments, and is compatible with other treatment types, including Rapid Arc™, VMAT, IMRT, IGRT, SBRT, protons and more. That system includes, among other things, a carbon fiber platform, various types of bridges, and two-pin bars that allows Body Pro-Lok components to index to treatment couches from various vendors, such as Varian, Siemens, Elekta and Tomotherapy. The treatment couchtops/overlays available from CIVCO make use of an array of equidistantly spaced indexing points running down the side of the couchtop/overlay to which the two-pin LOK-BAR™ is configured to be connected at any of the indexing points. In particular, to index a particular positioning/fixation device to the couchtop or overlay the LOK-BAR™ is attached to the couchtop or overlay via any of the multiple indexing points. The particular patient positioning/fixation device is then mounted on the LOK-BAR™. By indexing the patient positioning/fixation device(s) to the same indexing points for every radiation treatment one can be assured of increased target accuracy and patient throughput.
While other manufacturers provide couchtops/overlays with indexing systems and positioning/fixation devices to be used with such indexing systems to perform a specific method of patient positioning and/or immobilization and there are specific devices designed for various niche approaches to SBRT, what had been missing is a general solution for immobilizing patients that is sufficiently versatile to have broad appeal to multiple centers doing SBRT.
In U.S. Pat. No. 8,146,599 (Wilson et al.), which is assigned to the same assignee as the subject invention, and whose disclosure is incorporated by reference herein, patient positioning systems are disclosed which are modular in design and provide an integrated solution that allows the user to tailor the positioning and immobilization methods to suit the patient, their LINAC (or other therapy apparatus) and their treatment plan. The systems disclosed in that patent make use of various components, such as a portable platform (referred to as a “patient support panel”) and various devices for use on the patient support panel, so that when used patent comfort, setup time and patient transportation can be optimized. The patient support panel basically comprises a generally planar panel having a pair of side rails that enable full indexing of various components used during SBRT along its length. Among those components are modular multifunctional bridge devices that are arranged to be positioned anywhere along the length of the platform to be used to position/fix the patient or provide any other function desired during SBRT treatment. The multifunctional bridge devices are particularly significant in that they can be positioned where needed to provide various types of immobilization, hold instrumentation or enable stereotactic frames or other positioning and localization devices to be used.
While the bridge devices disclosed in the aforementioned patent and which are available from CIVCO are generally suitable for their intended purposes, they as well as other prior art bridge devices, leave something to be desired from various standpoints, such as the ability to achieve a wide range of adjustments, to shift laterally independent of the support platform and to enable each side of the bridge to be vertically adjustable independently to allow the angle of the central section of the bridge to vary relative to the surface of the support platform in the plane of the bridge. The subject invention addresses those needs.
All references cited and/or identified herein are specifically incorporated by reference herein.